2003, 03-31 Permit App: 03002096 RelocatePROJECT APPLICATION WORK SHEET
ii 1
SPOK,\NE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \VFST BRO:\DWz\Y AVENUE
SPOKz\NF, WA 99260
I "fin- i 509-477-3675
siFEUIVIV M IV, INrVKMAIIVN
Street Address: l E PJ
.\ssessor's Tax Parccl Number(s): Q
Legal Description:
Project Description: -rq `
S
❑ Building Permit ❑ Change in Use ❑ Grading ❑ -Manufactured Home Permit
❑ Relocation ❑ sign ❑ Tenant (New/Change) ❑ Other
Department Use Only
%'Vater District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Fa.:
Mailing Addifew
Mailing Address:
Front Rear.
School District
Fire District:
Zoning
City, State, Zip
Cite, State, Zip
I Icat sourct (el(ctric, gas, etc)
Left Right:
OWNER/APPLICANT INFORMATION
0 Indi,ale rvhn vhould Ge eanlarled renardini llii.r hroiet!
C�uner: Phone: y �a 7. ,0
C] Applicant:
Phone:
i c Nis 1' ev�t t a.: Nyd''.� �a. a
Unfinished basement sq. ft.
Fa.:
Mailing Addifew
Mailing Address:
Pinishcd basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
City, State, Zip
Cite, State, Zip
I Icat sourct (el(ctric, gas, etc)
�?f o31
Contractor Phone
❑ :UchitccC'kngnnccr
Phone
Fas
F -
Mailing address
Mailing a rese
l
City, State Zip
Stat Zip
(/(�
\C'A State Contractor livens
Building Information
Building height to peak
# >f [t1cs
Alain floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
' Ili floor sq. ft.
Pinishcd basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
I Icat sourct (el(ctric, gas, etc)
Manufactured Home
Sign
Width:
length:
What is the square footage of the sign
face?
I low high is the sign?
Year:
Make:
# of signs
Area ofexistingsigns
❑ Don't know ❑ Yes ❑ No
r__
Are or will there be wells located on the property?
Relocation
Dire Safety
Pt(6ous address
lire Sprinkler fent
Paint booth _ Fire Alarm _ Fireworks display _
Proposed use
\'aloe
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name Phone
Plans Examiner Phone
Inspectors:
Address
❑ Concrete ❑ Welding ❑ Bolting ❑ Reinforcement
Inspector Phone
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? ❑ Yes ❑ No
What is the current property size?
Ifyes, identify on site plan
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
What is the current use of this property?
Ifyes, identify onsite plan ❑ Yes ❑ No
❑ No
Is your property in a designated wildlife habitat area?
Will the site be served by a septic system? ❑ Yes ❑ No
❑ Don't know ❑ Yes ❑ No
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
Ifyes, identifi, on site plan
Ifyes, identij on the site plan ❑ Yes ❑ No
❑ Maybe ❑ Don't know ❑ Yes ❑ No
❑ Yes ❑ No
Are there any wetlands, streams or ponds within 200 feet of the property?
Is there evidence of fill or excavation on the property?
Ifyes, idemfij on site plan ❑ Yes ❑ No
❑ Yes ❑ No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
\ re critical or hazardous materials used or stored on site?
❑ Yes ❑ No
❑ Yes ❑ No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
Is public sewer available to the site? ❑ Yes ❑ No
❑ Yes
❑ No
Is the property inside the ASA? ❑ Yes
❑ No
Is public water available to the site? ❑ Yes ❑ No
❑ Yes
❑ No
Is the property inside the PSSA? ❑ Yes
❑ No
Is the property located within 1000 feet of a Natural Resource Area?
❑ Yes ❑ No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASH ❑ CIILCK ❑ � ❑ . wo, ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE::
EXPIRES:
SUKI'OTAL
TOTAL FEE
MINIMUM PERMIT FEE IS$35.WPL1. \ � 1:
.V . ViE CHECKS PAYABLL: TO SPOK:1\ I
COUNTY PER�NnT CENTER
0
ZONE SS
ROAD WITDT le r.;} ING
COW,IENTS
A -
A
GRACE AVENUE
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AREA=' 719 S.F.
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1 TYPE 8 DRYWECL.-_�__-,.. � : l �:. ;, •
SPOKANE COUNTY -,ST!). -'B -1Q
W/TYPt' 4 - FRAME--* GRATE _Ope
STA. 24-70.
70.81;-28 LT; (JOHNSON).. oy
RIM EL V. 1-996 75 zo o 4t X
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DCURB4ET TYPE 1. -SPOKANE r.V
COUNT :STD. 0-8 { iN; FEET)
STA. 2+$6.00 (JOHNSON) 1 inch = 20 ft NAL
EL.= 119§7.06 (FLOWLINE)
L- 4 EXPIRES 1/231 Olt
CHRISTIN'S ADDITION
STORHAUG ENGINEERING 2D8 LOT PLAN
1322 NORTH MONROE LOT 1. BLOCK 1
SPOKANE, WA 99201 DRAWN BY. JAM JT DATE: 04 24 0:
(509) 242-1000 CHECKED BY: MDW PROJECT No.: OC